[Cognitive 'Theory of Mind' processing in bipolar disorder]

Abstract

Objective: Bipolar disorder is associated to persistent functional impairments. Although many researches have shown that bipolar individuals might have cognitive deficits, a small number of studies evaluated the role of problems of social cognitive Theory of Mind processing (regarding the capacity to infer mental states) in the emergence of bipolar disorder's symptoms and its possible social poor outcomes. The objective of the present manuscript is to review systematically and critically the literature on Theory of Mind processing in bipolar disorder.

Method: A search in the electronic database Medline was conducted in order to find articles published in English, German, Spanish or Portuguese during the past 20 years, using the search phrase 'Bipolar Disorder'[Mesh] AND 'Theory of Mind'. Clinical studies have been searched, which involved bipolar individuals and that used one or more cognitive tasks developed to evaluate Theory of Mind abilities. Case reports and letters were excluded. The initial search retrieved 5 articles, out of them 4 were selected. Other 4 were also selected after reading the above mentioned articles.

Discussion: the selected articles evaluated populations of adult and pediatric bipolar individuals, including those in euthymia, mania and depression. The majority of the chosen manuscripts suggest that Theory of Mind processing problems might exist in bipolar individuals and that such problems might lie behind the symptoms and the functional deficits of bipolar disorder.

Conclusion: Additional research on the theme here discussed may shed light on the role of social cognitive problems in the emergence of bipolar disorder symptoms, as well as help developing preventive and therapeutic strategies for it.